Background
Medicare can be best described as a program, most commonly a social program that is put forward by the government of a country or state. It is a social insurance program. This scheme gives access to health services and health insurance to specific special groups in the society. This may include persons aged above sixty five on condition that they have worked and as well paid into the system. It may also include young people who might have physical disabilities in one way or another. Medicare is described as a social insurance program in the sense that unlike private insurance which regulates the premiums earned with respect to the level of risk involved, Medicare actually tends to spread its risk. In essence, the latter caters for the people who may not need the insurance and those who cannot use it. It spreads the risk, particularly the financial risk that is linked to ailments over and across the
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This is because it will lead to inequitable distribution of health services. Australia already experience huge economic disparities, where there is a very large gap that exists between the rich and the poor. Australian citizens are the major stakeholders in the Medicare scheme. It is therefore expected that an extra charge would affect the living standards adversely.
Efficiency, fairness and quality should be the primary goals of Medicare. In essence, Medicare should ensure that in all its policies, it strives to deliver payments and service on a very fair level of operation. It should also show the beneficiaries the value for their money through efficiency in the provision of their services and quality in terms of the standards of their services as well as their outcomes. The fact that the system is funded mainly through progressive taxation has ensured equity; however, this is what has mainly led to economic
Have you ever been sick? Chances are you have. Medical care is very expensive; a simple check-up can cost up to and over $100. If a check-up costs that much money, think about how much an operation might cost. If it weren’t for Medicare or (Free) Universal Health Insurance, it is possible that some of you would be bankrupt by now. The inventor of this system is Tommy Douglas, voted the greatest Canadian of all time by the CBC broadcasting channel. This remarkable man was the former premier of Saskatchewan for 17 years and the father of Medicare.
(II) The enacting of Medicare Part D in 2006 only helped to fuel America’s hunger for prescription medication. In 2003, President George W. Bush announced and signed the Medicare Prescription Drug, Improvement, and Modernization Act (also known as the Medicare Modernization Act, or MMA) on December 8th. The roughly $400 billion dollar measure was marketed to the American public as something that will provide care for the millions of senior citizens who, at the time, were struggling to afford prescription medication. This was the largest development of Medicare since 1965, which is when the program was initially created, and gave hope to those wishing for positive medical reform. According to title XI of the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003”, the most significant change will be the affordability of prescription drugs by implementing the importation of drugs from Canada, along with necessary safety measures, in order to lessen the cost (United States Congress, 832). For those who were in retirement homes and lacked a steady income, the affordability of drugs was often a deciding factor in the decision to seek medical attention and the idea that those individuals ceased to live simply because they lacked the funds tugged at the heartstrings of many Americans.
Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities and people of any age with End-Stage Renal Disease. There are four subcategories of Medicare. Part A is for hospital stays or, with certain restrictions, at-home care for a limited number of days. Part B is more like regular medical insurance. It covers ambulatory care and physician fees. There is a deductible and are sometimes co-pays as well. Part C is presented as an alternative to parts A and B. It is where private insurance companies can contract with the federal government to offer Medicare benefits through their own policies. It can offer benefits not covered under original Medicare, although there might be a premium charged. Part D is the prescription plan for enrollees. (Centers for Medicare and Medicaid Services, 2010)
Such rising health care costs penalize the citizens within our nation in multiple aspects. The first set of individuals that are affected are families and seniors because it affects the amount of money that goes into their pockets, which results in a difficult time balancing food, rent, and the basic necessities for living. Next, small businesses and fortune 500 employers are affected because such increased costs cause rising health care costs to become more expensive to add new employees to their payroll and more difficult to cover retiree fees when that time comes. Finally, the federal, state, and local governments are forced to increase Medicare and Medicaid costs, which results in cutting other priority funding such as public safety and education.
On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173). This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration during Congressional debate. The inaccurate figure helped secure support from fiscally conservative Republicans. It was reported that an administration official, Thomas A. Scully, had concealed the higher estimate and threatened to fire Medicare Chief Actuary Richard Foster if he revealed it. By early 2005, the White House Budget had increased the 10-year estimate to $1.2 trillion.
In 1965 President Johnson signed both Medicare and Medicaid programs into law (Nile, 2011). According to Medical news today, “Medicare is a social insurance program that serves more than 44 million enrollees as of 2008” (MediLexicon International Ltd, 2011, para2). It cost about $432 billion or 3.2% of GDP, as of 2007(par2).Medicare is broken down into parts, Part A is hospital Insurance Part B is medical Insurance, and Part D is Medicare prescription drug coverage (medicare.gov). Like we previously stated Medicare is a health insurance for people who are 65 and older, people under 65 with certain disabilities, and people of any age with End- Stage Renal Disease. Medicaid is a joint federal-state program of medical assistance for low income persons (Benefit.gov). It is administered by the Illinois Department of Human Services (DHS) and Illinois Department of Public Aid (IDPA). Medicaid serves about 40 million people as of 2007; it cost $330 billion, or 2.4% of GDP, in 2007.(par.2) “In Illinois you may be eligible for Medicaid if you are a child, pre...
for Medicare, you must meet certain conditions. A person qualifies if they are 65 years of age
Medicare provides healthcare coverage for individuals over the age of 65, in addition, to others meeting certain criteria. The government funds Medicare through the administration of the federal Centers for Medicare and Medicaid and spends billions annually, on the program. Fraud runs rampantly throughout the healthcare program due to the enormous amount of money spent and the large number of people enrolled in the program. Fighting fraud of this nature necessitates diligence by everyone. Protecting oneself entails understanding what constitutes fraud, identifying it, noting suspicious practices, and taking steps towards prevention.
According to Medicare’s WebPage Medicare is a Health Insurance Program for people 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare has two parts, Part A which is for basically hospital insurance. Most people do not have to pay for Part A. In addition it has a Part B, which is basically medical insurance. Most people pay a small monthly fee for Part B. Medicare first went into effect in 1966 and was originally administered by the Social Security Administration. In 1977 the control of it was switched over to the newly formed Health Care Financing Administration. Beginning in July 1973 Medicare was extended to persons under the age of 65 with certain disabling conditions. In 1988 Congress passed legislation to expand the program to cover health care costs of catastrophic illnesses.
There are many reasons as to why healthcare is more expensive in the United States than any other country. One of them is because of the high profit margins that are protected by pharmaceutical companies. In other countries like the UK, the government can negotiate lower prices which brings down the cost, while the US is stuck paying higher prices because legislation greatly reduces negotiating power of the US government. Another reason is that consumers in America are not the direct payer, therefore, they generally do not care about how much providers charge because it does not directly affect them (through direct pay or taxes). Along the same lines, in many other countries, the government is the only buyer of medical services because patients pay for services through taxes. This causes the healthcare market to essentially be a “buyer’s market,” which drives the cost down. Another major reason for expensive healthcare is because American doctors are paid much more than doctors in other countries. A big part of this has to do with the very long and expensive road of medical school in the US, necessitating that doctors get paid more so that the process is worth it for them financially. Finally, the healthcare system is very bloated, with payments usually going through multiple intermediaries and each insurance company taking a percentage of the payment. The government does not regulate the costs in the industry very well, essentially creating a “seller’s market.” These are just some of the reasons of why the most expensive healthcare in the world is in the United
Medicare and Medicaid are two of the United States largest broken systems, which must sustain themselves in order to provide care to their beneficiaries. Both Medicare and Medicaid are funding by a joint effort between the federal government and the local state government. If and when these governments choose to cut funding or reduce spending, Medicare and Medicaid take the biggest hit. Most people see these two benefits as one in the same, two benefits the government takes out of their pay check to help fund health care. While the government does deduct a sum from paychecks everywhere, Medicare and Medicaid are very two very different programs.
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Medicare and Medicaid are programs that have been developed to assist Americans in attainment of quality health care. Both programs were established in 1965 and are federally supported to provide health care coverage to vulnerable populations such as the elderly, the disabled, and people with low incomes. Both Medicare and Medicaid are federally mandated and determine coverage under each program; both are run by the Centers for Medicare & Medicaid Services, a federal agency ("What is Medicare? What is Medicaid?” 2008).
One in six Americans and mostly all of the population 65 years and older, are covered by Medicare. In 2012, Medicare provided for 50.7 million people, 42.1 million aged and 8.5 million disabled, with a total cost of $574 billion. This is about 21% of national health spending and 3.6% of Gross Domestic Product (Davis, 2013). Medicare, being a social insurance program, is required to pay for covered services provided to enrollees so long as the specific criteria is met. On av...
Reforming the health care delivery system to progress the quality and value of care is indispensable to addressing the ever-increasing costs, poor quality, and increasing numbers of Americans without health insurance coverage. What is more, reforms should improve access to the right care at the right time in the right setting. They should keep people healthy and prevent common, preventable impediments of illnesses to the greatest extent possible. Thoughtfully assembled reforms would support greater access to health-improving care, in contrast to the current system, which encourages more tests, procedures, and treatments that are either